Bernard Paulais Marie-Anna, Mazetto Camilla, Thiébaut Eric, Nassif Maria Clara, Costa Coelho De Souza Maria Thereza, Stefani Ana Paula, Blanc Romuald, Gattegno Maria Pilar, Aïad Fethia, Sam Nadia, Belal Lina, Fekih Laid, Kaye Kelley, Contejean Yves, Wendland Jaqueline, Barthélémy Catherine, Bonnet-Brilhault Frédérique, Adrien Jean-Louis
Laboratory of Psychopathology and Health Processes (EA n°4057), Institute of Psychology, University of Paris, Paris, France.
Psychology Office ESPAS-IDDEES, Pont-Ste-Maxence and Bordeaux, France.
Front Psychiatry. 2019 Jul 19;10:508. doi: 10.3389/fpsyt.2019.00508. eCollection 2019.
Intellectual disability (ID) is frequently associated as a comorbidity in autism spectrum disorders (ASD). This study investigated a) how similar the heterogeneity in the cognitive and socio-emotional developmental profiles was for children with ASD and ID, b) the difference between the subjects' profiles and those of typically developing children (TD) matched for developmental levels, c) the skills existing with the lowest and highest developmental levels, and d) the relationship between developmental profiles in ASD and the severity of autism, ID, and the overall developmental level. The sample was comprised of 119 children (101 boys and 18 girls) who ranged in chronological age (CA) from 21 months to 14 years ( = 5 years 2 months; SD = 2 years 6 months) with developmental levels lower than 24 months. They came from three countries (France = 40, Brazil = 40, and Algeria = 39). The control group was comprised of 40 TD children from these same countries who ranged in CA from 4 to 24 months ( = 1 year 3 months; SD = 5 months). The ASD diagnosis was carried out according to International Statistical Classification of Diseases and Related Health Problems-10th Edition (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR), Diagnostic and Statistical Manual of Mental Disorders-5th ed (DSM-5) criteria and the Childhood Autism Rating Scale (CARS). Children were tested using the Social Cognitive Evaluation Battery (SCEB; Adrien, 2007) by trained psychologists from public and private institutions specialized in the diagnosis of autism and interventions in this field. The SCEB explores 16 functional abilities, in both cognitive and socio-emotional areas, and allows the calculation of domain and area developmental levels and heterogeneity indices for the global, cognitive, and socio-emotional areas. Children with ASD developmental profiles show very high heterogeneity as opposed to TD children. Regardless of the country of origin, there are similarities between the heterogeneous cognitive and socio-emotional developmental profiles of the children with ASD, whose profiles are characterized by lower developmental levels of language and vocal imitation skills, and a relationship between these developmental heterogeneities and the degree of severity of autistic symptomatology, intellectual disability, and overall development level. The implications of this study are presented for clinical assessment and intervention purposes in ASD and ID.
智力障碍(ID)常作为自闭症谱系障碍(ASD)的一种共病存在。本研究调查了:a)ASD和ID儿童在认知及社会情感发展概况方面的异质性有多相似;b)研究对象的概况与发育水平相匹配的正常发育儿童(TD)的概况之间的差异;c)发育水平最低和最高的儿童所具备的技能;d)ASD的发育概况与自闭症严重程度、ID及总体发育水平之间的关系。样本包括119名儿童(101名男孩和18名女孩),其实际年龄(CA)从21个月至14岁不等(平均年龄=5岁2个月;标准差=2岁6个月),发育水平低于24个月。他们来自三个国家(法国40名、巴西40名、阿尔及利亚39名)。对照组由来自这些相同国家的40名TD儿童组成,其CA范围为4至24个月(平均年龄=1岁3个月;标准差=5个月)。ASD诊断依据《国际疾病分类及相关健康问题统计手册》第10版(ICD - 10)、《精神疾病诊断与统计手册》第4版,修订版(DSM - IV - TR)、《精神疾病诊断与统计手册》第5版(DSM - 5)标准以及儿童自闭症评定量表(CARS)进行。儿童由来自专门从事自闭症诊断及该领域干预的公立和私立机构的训练有素的心理学家使用社会认知评估量表(SCEB;阿德里安,2007)进行测试。SCEB探究了认知和社会情感领域的16种功能能力,并允许计算全球、认知和社会情感领域的领域及区域发育水平和异质性指数。与TD儿童相比,ASD发育概况的儿童表现出非常高的异质性。无论原产国如何,ASD儿童异质性的认知和社会情感发展概况之间存在相似性,其概况的特征是语言和发声模仿技能的发育水平较低,并且这些发育异质性与自闭症症状、智力障碍的严重程度以及总体发育水平之间存在关联。本研究的意义针对ASD和ID的临床评估及干预目的进行了阐述。